Unilateral Choanal Atresia

The two nasal cavities begin at the nostrils, and tunnel straight back to the throat, which is called the nasopharynx (throat at the level of the nose). The holes through which the nasal cavities connect to the throat are called the choanae (singular: choana). In rare situations as an embryo, one or both of the choanae remain closed. Newborns require nasal breathing to survive, so if both choanae are closed, it is an emergency, and they must be opened surgically. However, if only one is closed, it is not necessarily an issue for the child, and they just grow up with one-sided nasal obstruction and perhaps nasal drainage. People are bothered by these two issues to different degrees, but if not terribly bothered, they might not seek out an ENT surgeon’s evaluation, so the problem goes undiagnosed. This was the case for the patient presented in this video. She lived over 30 years without being able to breathe through the right side of her nose, and had frequent thick right-sided nasal drainage. Fortunately, she was evaluated eventually and found to have right-sided choanal atresia, which was readily correctable with endoscopic surgery, as was performed by Dr. John Craig at Henry Ford Hospital in Detroit, MI. The cross-over flap technique shown in this video is a reliable method for maintaining a patent choanal opening postoperatively.